title: Immunonutrition with long-chain fatty acids prevents activation of macrophages in the gut wall.
abstract: BACKGROUND
  Immune cells and inflammatory mediators are released from the gastrointestinal tract into the mesenteric lymph during sepsis causing distant organ dysfunction. Recently, it was demonstrated that macrophages in the gut wall are controlled by the vagus nerve, the so-called cholinergic anti-inflammatory pathway.
  
  
  OBJECTIVE
  This study aims to investigate whether an enteral diet with lipid prevents the activation of leukocytes in the gut wall.
  
  
  METHODS
  Mesenteric lymph was obtained from rats, receiving an enteral infusion of glucose or glucose + lipid before and after lipopolysaccharide (LPS) injection. Immune cells in mesenteric lymph were analyzed with fluorescence-activated cell sorting before and after LPS injection. Mesenteric lymph leukocytes from rats receiving enteral glucose with or without lipid were stimulated in vitro with LPS and tumor necrosis factor (TNF)α was measured in the supernatant.
  
  
  RESULTS
  The release of macrophages from the gut during sepsis was not significantly different in animals enterally treated with glucose or lipid. However, the release of TNFα from mesenteric lymph leukocytes after in vitro LPS stimulation was more than 3-fold higher in the glucose group compared to the lipid-treated group.
  
  
  CONCLUSIONS
  During sepsis, activated macrophages are released from the gut into mesenteric lymph. However, an enteral diet with lipid is able to suppress the inflammatory cytokine release from mesenteric lymph leukocytes.
authors.affiliation: Department of General and Transplant Surgery, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Friederike
authors.initials: F
authors.lastname: Eisner
authors.forename: Petra
authors.initials: P
authors.lastname: Jacob
authors.forename: Julia-Stefanie
authors.initials: JS
authors.lastname: Frick
authors.forename: Maximilian
authors.initials: M
authors.lastname: Feilitzsch
authors.forename: Julia
authors.initials: J
authors.lastname: Geisel
authors.forename: Mario H
authors.initials: MH
authors.lastname: Mueller
authors.forename: Markus A
authors.initials: MA
authors.lastname: Küper
authors.forename: Helen E
authors.initials: HE
authors.lastname: Raybould
authors.forename: Ingmar
authors.initials: I
authors.lastname: Königsrainer
authors.forename: Jörg
authors.initials: J
authors.lastname: Glatzle
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004750:Enteral Nutrition / Q000379:methods*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D007111:Immunity, Cellular; D007413:Intestinal Mucosa / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D008196:Lymph / Q000276:immunology; D008262:Macrophage Activation / Q000187:drug effects*; D008264:Macrophages / Q000187:drug effects / Q000276:immunology*; D008297:Male; D008643:Mesentery / Q000276:immunology* / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D018805:Sepsis / Q000276:immunology / Q000473:pathology / Q000517:prevention & control
chemical_list: D015525:Fatty Acids, Omega-3